Worker's
Compensation for Nurses and other Health Care Workers
This brochure
presents information that will assist you, the employee to:
- understand
your responsibilities as the worker in obtaining benefits.
- understand
your employers responsibilities as the insured party.
- locate
sources of information to support your claim to replace your lost
income.
Workers' Compensation is an insurance system that partially replaces
wages and pays related medical expenses if you prove that you are injured
on the job or develop a work related illness.
Healthcare
workers have suffered various injuries and illnesses such as back and
neck strains, needlestick injuries, latex allergy, asthma, dermatitis,
chemical exposure, and multichemical sensitivity.
These health
conditions have been caused or aggravated directly or indirectly by
the places and/or the conditions of employment.
If you
experience a job related injury or illness inform your employer immediately.
Your employer begins the claims process which includes notification
of the Department of Industrial Accidents and the Worker's Compensation
insurance carrier. The insurance carrier issues you a claim number.
You need to give this number to your doctor or healthcare provider so
your claim is correctly billed for the necessary care and treatment.
You must inform the doctor or healthcare provider that you are seeking
treatment for a work related injury or illness. If they accept you as
a patient, they are agreeing to bill the insurance carrier. The
insurance company is responsible for the entire bill. You are not required
to pay copayments.
Occupational
illnesses and injuries present unique problems related to treatment,
record keeping and confidentiality issues. You may need to consult with
a physician or healthcare provider who is specially trained in occupational
medicine or occupational health nursing.
A consultation
with and representation by an attorney specializing in employment law
should be considered when:
- you
anticipate loosing time from work and will lose wages.
- you
feel that your interests are not being served by your employer.
- your
employer becomes adversarial to your needs for your health, your financial
condition, your medical care, or your job security.
The attorney's fees are usually subtracted when there is a lump sum
settlement. The initial consultation is free. You should ask about this
when you make the appointment.
A Workers' Compensation Claim is addressed on an individual basis.
There are multiple steps in this very complicated process. The steps
are known as conciliation, voluntary arbitration, conference, hearing
and appeal.
The Massachusetts
Department of Industrial Accidents (DIA) has a public information person
available to answer questions and upon request will provide a booklet
entitled, "Your Guide to the Massachusetts Workers' Compensation
System - For Injured Workers".
(DIA)
Regional Offices
Boston — 617.727.4900
Fall River — 508.676.3406
Lawrence — 978.683.6420
Worcester — 508.753.2072
Springfield — 413.784.1133
Benefit Summary
- The
insurer must either pay benefits or send a notice of denial, with
explanation, within 14 days of receiving First Report of Injury.
- If
you qualify for benefits the insurer may pay up to 180 days without
accepting responsibility. This is called "Pay Without Prejudice".
The insurer may stop or reduce payments by giving seven days notice.
If they pay past the 180 days, the insurer needs permission from you
or a judge to stop or reduce benefits.
- If
denied benefits it is your right to appeal the decision.
Workers Compensation Benefits are limited to:
- medical
bills are paid that are directly related to the claim.
- lost
wages are paid in varying amounts depending on your disability as
determined by the judge who presides at your hearing.
- vocational
rehabilitation services if you are unable to return to your job.
Responsibilities of the Injured Worker include:
- reporting
your injury/exposure/illness as soon as possible.
- obtaining
a claim number.
- informing
healthcare providers that you are seeking treatment for a work related
illness or injury.
- obtaining,
from your employer, all MSDS related to your job if your
illness is related to chemical/environmental exposures.
An Occupational (work-related) Injury is any injury which results
from a work accident or from a single instantaneous exposure in the work
environment. Musculo-skeletal injuries often happen over time and should
be reported as soon as you become aware of pain or discomfort.
An Occupational
(work-related) Illness is any abnormal condition or disorder, other
than one resulting from an occupational injury, caused by exposure to
environmental factors associated with employment. It includes acute
and chronic illnesses or diseases which maybe caused by inhalation,
absorption, ingestion, direct contact or repeated trauma.
Recognize
an injury or illness may be considered occupational if it is
attributed to an occurrence, event, or process within the work environment.
Report
injuries, illness or exposures to workplace hazards or symptoms
related to the work environment immediately. The report should be made
to your supervisor and the person responsible for employee health and
safety in your facility.
Document,
Document, Document
The First
Report of Injury must be filed with Department of Industrial Accidents
by your employer within 7 business days of your fifth calendar day of
disability or inability to work. You must obtain a copy of the First
Report of Injury (also called the OSHA 101).
The insurance
carrier who pays your bills is identified on this form.
Develop
a Personal Record. That includes:
Dates, events, symptoms, incident reports, health care provider
exams, workplace records and personal logs.
Keep
a copy of all
written reports for your records.
OSHA General Duty Clause 5(A)(1)
Employers
(in the private sector) must comply with Occupational Safety and Health
Act Standards issued under the Occupational Safety and Health Act of
1970. Section 5(A)(1) states, employers must furnish employees, employment
and a place of employment free from recognized hazards that are causing
or are likely to cause death or serious harm to employees.
OSHA does
not cover workers in the public sector in Massachusetts. Public sector
workers are protected by MA. Right to Know laws and have Whistleblower
Protection when reporting hazardous conditions to the Attorney General's
office.
Reporting
Hazardous Conditions to OSHA
As an employee,
it is your right to report uncorrected work place hazards to OSHA. Another
resource to report to is your union. OSHA will investigate claims of
unsafe conditions and require that they be corrected. The employer may
be assessed penalties for failure to protect employees..
OSHA
Requirements
OSHA requires
employers to provide Material Safety Data Sheets (MSDS) for every chemical
used in the workplace. Employers are also required to make the MSDS
available to all workers during each shift. Copies of MSDS are to be
provided by the employer at no charge.
Americans
with Disabilities Act (ADA) of 1990
The ADA
defines a person with a disability as anyone with "a physical or mental
impairment that substantially limits one or more of the major life activities,
a record of such impairment, or being regarded as having such an impairment".
Discrimination
against the handicapped is prohibited in all aspects of the employment
process including applicant testing, hiring assignments, evaluation,
disciplinary training, promotion, medical examinations, layoff, termination,
compensation, leaves-of-absence. Reasonable accommodations is required
unless it would impose undue hardship on the employer or result in a
safety hazard to others.
Resources
Nursing Resources:
- American
Association of Occupational Health Nurses
770.455.7757
Legal
Resources:
- Disability
Law Center
617.723.8455
Federal
Resources:
- U.S.
Federal Information
800.688.9889
- Occupational
Safety & Health Administration (OSHA)
202.219.8131
- Nat'l.
Inst. of Occupational Safety & Health (NIOSH)
800.356.4674
- Environmental
Protection Agency (EPA)
202.382.7548
- Agency
for Toxic Substance and Disease Registry (ATSDR)
617.918.1491
- Social
Security Administration
800.772.1313
Massachusetts
Resources:
- Department
of Industrial Accidents (DIA)
Regional Offices
Boston — 617.727.4900
Fall River — 508.676.3406
Lawrence — 978.683.6420
Worcester — 508.753.2072
Springfield — 413.784.1133
- Department
of Public Health
617.624.6000
617.624.5621
617.624.0000
- Department
of Labor and Industries
617.727.3452
- Massachusetts
Committee on Occupational Safety & Health MassCOSH: 617.524.6686
Western MassCOSH: 413.731.0760
The following booklet, available from Western MassCOSH, may be
helpful to assist in answering some of your questions. Hurt on the
Job.
National
Resources:
- National
Institute of Environmental Health & Safety
800.NIEHS.94
- Allergy
to Latex Education Resources Team (ALERT)
414.677.9707
- Massachusetts
Association for the Chemically Injured
978.681.5117
